National Award honors a career combining medicine and pediatrics

June 1, 2000

DAYTON, OHIO -- A new national award has been named in honor of a physician at Wright State University School of Medicine. The National Medicine-Pediatrics Residency Association (NMPRA) created the Gary Onady Award in recognition of his "notable, extraordinary, lasting contributions" to the specialty of medicine/pediatrics (Med/Peds), which provides medical care for children and adults.

Onady is associate professor of medicine and pediatrics and director of the Combined Medicine/Pediatrics Residency Program at Wright State. He is a member of University Medical Services Association (UMSA), the group medical practice operated by Wright State faculty, and sees patients at the Frederick A. White Health Center at Wright State and at Children's Medical Center and other area hospitals.

A 1987 graduate of Wright State University School of Medicine, Onady completed his own Med/Peds residency training at Metro General Hospital in Cleveland. He also holds a Ph.D. degree in chemistry from the City University of New York.

Physicians trained in Med/Peds can practice as pediatricians and internists, treating patients of all ages. Med/Peds as a specialty has reached "young adulthood" in recent years, according to Onady. The first combined residency was approved in 1967; today there are 102 Med/Peds residencies nationwide. A 1999 survey found that 81% of Med/Peds physicians achieve certification from both the American Board of Internal Medicine (ABIM) and the American Board of Pediatrics (ABP).

"I chose Med/Peds as a career because I wanted diversity in my medical practice," Onady says. "As a pediatrician, I can manage a wide spectrum of acute and chronic illnesses of childhood, and I can anticipate how these will affect the child's development into adulthood. As an internist, I can combine this anticipatory guidance with health promotion and disease prevention for adults."

A case in point is cystic fibrosis (CF), a genetic disease that leads to destruction of the lungs and other problems. Prior to the 1940s, a CF patient's life expectancy was 6 months. With the use of antibiotics and aggressive physical therapy, over half of CF patients now survive to adulthood.

"The oldest patient in my practice is 65 years old. The majority of my CF patients are in their mid-30s," Onady says.

As a child with CF matures to adulthood, the disease's long-term complications can include diabetes, kidney and intestinal problems, progressive lung disease, and the psychosocial consequences of living with chronic illness. "All of these medical problems are in the realm of the internist's expertise, but are less familiar in the pediatric spectrum of illnesses," Onady explains. "The Med/Peds generalist is well experienced in handling many of these issues without the need for an army of sub-specialists."

During the transition from childhood to adulthood, Onady provides continuity of care for CF patients as well as their families. He believes the Med/Peds model for transitional care can be effective for managing other chronic illnesses such as childhood cancer survivors, asthma, cerebral palsy and muscular dystrophy.

Throughout his career Onady has been active nationally to promote medicine/pediatrics as a specialty. He served as president of the Medicine-Pediatrics Program Directors Association and represented that group on the Primary Care Organizations Consortium, which coordinates a national health-care agenda with other primary care specialties. He has consulted with the ABIM and ABP to revise the Med/Peds training curriculum. This year he became the first national advisor of the NMPRA, which represents the needs and interests of Med/Peds residents across the country.

"It has been a very rewarding experience to be involved with the NMPRA at its initiation," Onady says. "I have been fortunate to have entered Med/Peds on the ground floor so that my career has evolved along with the specialty. I hope the Onady Award will challenge future Med/Peds residents to make lasting contributions to the specialty."